Transcript Cartilage

Institute of Anatomy @ PMU Salzburg
Paracelsus Medical University | Strubergasse 21, A-5020 Salzburg | www.pmu.ac.at
Team at the Institute of Anatomy
Prof. Felix Eckstein, MD
Martin Hudelmaier, MD
Anja Ruhdorfer, MD, PhD
Sebastian Cotofana, MD
Torben Dannhauer, PhD
Wolfgang Wirth, PhD
Chondrometrics GmbH
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Founded in 2003
CEO: Prof. Felix Eckstein
Provides quantitative cartilage analyses for industry & academia
Overlap of people between PMU & CHM
Institute of Anatomy
 Research focus:
» Knee osteoarthritis
» Structural changes of cartilage and surrounding tissues
» Morphometric analyses
Portfolio
 Morphometric analyses
» Usually MRI-based
» Manual or semi-automated segmentation
» Dedicated software
Cartilage
Meniscus
Thigh muscles
Portfolio: Cartilage
 Measurement of:
» Cartilage thickness
» Cartilage volume
» Cartilage areas (subchondral bone area/
cartilage surface area)
P TrF
pLF
cLF
 High-resolution, high-field MRI
 Manual segmentation with quality control
readings
cLF
LT
cMF
LT
MT
cMF
cLF
MT
LT
Portfolio: Cartilage composition
 Measurement of T2 (spin-spin) relaxation time
 Multi-echo spin-echo MRI
 Spin-spin relaxation time in cartilage:
» Collagen content
» Collagen orientation
» Water content
 Manual segmentation with QC readings
19.4 ms
38.8 ms
58.2 ms
Portfolio: Meniscus
 Measurement of:
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3D meniscus extrusion
3D meniscus morphology
Tibia plateau coverage
Regional analysis
 Manual segmentation with QC readings
Portfolio: Muscle
 Measurement of:
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3D thigh muscle volume
2D anatomical cross-sectional areas (ACSA)
Inter-muscular tissue
Subcutaneous fat
Femoral medulla & corticalis
 T1 weighted spin-echo MRI
 Manual / semi-automated segmentation
Osteoarthritis Initiative (OAI)
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Longitudinal multi-center study (8 years)
4796 Participants (45-79 years at baseline)
Data and image assessments publicly available
Focus:
» Identification and evaluation of risk factors for incidence / progression of knee OA
» Validation of imaging biomarkers
 http://www.oai.epi-ucsf.org
OAI: Available assessments
 Assessments:
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Isometric strength
Physical activity scores
Alignment measurements (full-limb x-rays, knee x-rays)
Physical performance examinations
Knee examination (Joint laxity, …)
Semi-quantitative KLG, JSN, osteophyte readings
Radiographic joint space width
MRI-based cartilage thickness, meniscus, muscle measurements
 Questionnaires:
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Pain (severity, frequency)
Function
Quality of Life
Medication
Nutrition
Occupation
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OAI Thigh MRI
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Acquisition started 100mm proximal to the distal epiphyseal line
Covers 15 slices (5mm slice thickness)
T1-weighted spin-echo MRI
Computation of comparable slices between subjects required
Specific strength (strength / ACSA)
Muscle groups
• Quadriceps
• Hamstrings
• Adductors
• Sartorius
Quadriceps heads
• Vastus medialis
• Vastus intermedius
• Vastus lateralis
• Rectus femors
ESR10: Muscle morphology and osteoarthritis
disease progression
 Objectives:
» To identify the role of muscle tissue characteristics in predicting OA joint damage
» To assess the impact of joint biomechanics on this relationship
 Profile:
» Background: Engineering / computer science ?
» 2 years+ PhD program (doctorate of medical sciences)
» KneeMo funding: 3 years
 Project:
» Automation of the segmentation of muscle ACSAs
» Quantitative analysis of muscle ACSAs in OAI participants with and without
progressive cartilage thickness loss
ESR10: Muscle morphology and osteoarthritis
disease progression
 Cohort selected by the OAI coordinating center (n=445 with Y4 FU)
 KLG 2/3 knees (established radiographic OA)
BL
Y1
Cartilage thickness
Y2
Y3
Y4
Non-progressors
Cartilage thickness
Progressors
Muscle ACSA
Muscle ACSA
» Comparison of change in muscle ACSAs between participants with and without
severe cartilage loss (matched cases & controls)
» Combination with other assessments (e.g. alignment, knee injuries, joint laxity,
meniscus surgery)
ER3: Predicting OA outcome through muscle tissue
characteristics
 Objective: To establish the predictive value of structural and
physiological factors on outcome in KOA
 Profile:
» Background: Life sciences
» KneeMo funding: 2 years
 Project:
» Quantitative analysis of muscle ACSAs in OAI participants, that
underwent total knee replacement surgery
» Case-control study with up to 4 years prior to surgery (n=222+)
» Available assessments:
• Cartilage thickness measurements
• Meniscus measurements
• Semi-quantitative MRI readings (cartilage lesions, ligaments,
bone-marrow lesions, …)
ER3: Predicting OA outcome through muscle tissue
characteristics
 Cohort selected as part of the OAI POMA project (Kwoh & Hunter)
 Knees with confirmed knee replacement surgery
Y2
Y3
Y4
BL
Y1
T-3
T-2
T-1
T-4
T-3
T-2
T-1
T-5
T-4
T-3
T-2
T-1
T-6
T-5
T-4
T-3
T-2
Y5
Y6
T0
T0
T0
T-1
T0
Y7
Exchange
 Anatomy training
» Lectures
» Dissection course
 Quantitative image analysis
» Background (MRI)
» Techniques
 Small projects?
» Based on data from the OAI
» Quantitative analysis of a small cohort
Anatomy training
NanoDiaRa project meeting